Как развивается ваш ребенок? - страница 3

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Фамилия, имя ................................................................................................

Город .....................................................................................................................

Адрес ....................................................................................................................

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Возраст .................................... Дата рождения ..........................

Первое обследование ............................................................................

Второе обследование .............................................................................

Третье обследование ...............................................................................

Для заметок лечебного педагога

1. Предыстория (анамнез): ..................................................................

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